Department of Psychology, San Diego State University, 5500 Campanile Drive, San Diego, CA, 92182, USA; Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California San Diego, 9500 Gilman Drive, La Jolla, CA, 92093, USA.
Human Development and Family Sciences, University of Delaware, Newark, DE, 19716, USA.
Drug Alcohol Depend. 2021 Jun 1;223:108706. doi: 10.1016/j.drugalcdep.2021.108706. Epub 2021 Apr 20.
Substance use-related stigma is a significant barrier to care among persons who use drugs (PWUD). Less is known regarding how intersectional identities, like gender, shape experiences of substance use-related stigma. We sought to answer the following question: Do men or women PWUD experience more drug use stigma?
Data were drawn from a systematic review of the global, peer-reviewed scientific literature on substance use-related stigma conducted through 2017 and guided by the Stigma and Substance Use Process Model and PRISMA guidelines. Articles were included in the present analysis if they either qualitatively illustrated themes related to the gendered nature of drug use-related stigma, or quantitatively tested the moderating effect of gender on drug use-related stigma.
Of the 75 studies included, 40 (53 %) were quantitative and 35 (47 %) were qualitative. Of the quantitative articles, 22 (55 %) found no association between gender and drug use-related stigma, 4 (10 %) identified women who use drugs (WWUD) were more stigmatized, and 2 (5 %) determined men who use drugs (MWUD) were more stigmatized. In contrast, nearly all (34; 97 %) of the qualitative articles demonstrated WWUD experienced greater levels of drug use-related stigma.
The quantitative literature is equivocal regarding the influence of gender on drug use-related stigma, but the qualitative literature more clearly demonstrates WWUD experience greater levels of stigma. The use of validated drug use-related stigma measures and the tailoring of stigma scales to WWUD are needed to understand the role of stigma in heightening the disproportionate harms experienced by WWUD.
药物使用相关污名是药物使用障碍者（PWUD）接受治疗的一个重大障碍。对于性别等交叉身份如何影响药物使用相关污名的体验，我们知之甚少。我们试图回答以下问题：男性 PWUD 还是女性 PWUD 经历更多的药物使用污名？
本研究的数据来自于 2017 年对全球同行评议的药物使用相关污名的科学文献进行的系统综述，该综述以污名与药物使用过程模型和 PRISMA 指南为指导。如果文章定性地说明了与药物使用相关污名的性别特征相关的主题，或者定量地检验了性别对药物使用相关污名的调节作用，则将其纳入本分析。
在纳入的 75 项研究中，40 项（53%）为定量研究，35 项（47%）为定性研究。在定量研究中，22 项（55%）研究未发现性别与药物使用相关污名之间存在关联，4 项（10%）研究表明女性药物使用者（WWUD）受到更多污名化，2 项（5%）研究表明男性药物使用者（MWUD）受到更多污名化。相比之下，几乎所有（34 项；97%）定性研究都表明 WWUD 经历了更高水平的药物使用相关污名。
定量文献对于性别对药物使用相关污名的影响存在争议，但定性文献更清楚地表明 WWUD 经历了更高水平的污名。需要使用经过验证的药物使用相关污名测量工具，并针对 WWUD 定制污名量表，以了解污名在加剧 WWUD 所经历的不成比例的伤害中的作用。
